New visitation principles proposed for critical patients during pandemic
End-of-life patients and those with serious illnesses may soon be able to have visitors under specific recommendations, as the COVID-19 pandemic continues in Texas.
The Texas Medical Association (TMA) and several other statewide health organizations addressed the need for in-person visitations for patients in health care and long-term care facilities in a letter to the governor and the Texas Health and Human Services Commission. The state agency recently extended for 60 days a temporary order restricting visitation for some facilities. TMA President Diana L. Fite, MD, said while limiting visitors aims to lower the risk of exposure and prevent the spread of COVID-19 among patients, health care workers, and visitors, the current regulatory restrictions also affect patients’ well-being.
“Our organizations wish to recognize the mental, emotional, spiritual, and other health needs of the patient that may be unmet with strict, limited, or ‘no visitation’ policies,” Dr. Fite said. “We simply are trying to balance patients’ and their loved ones’ need to see one another during a critical time with the need to prevent the spread of disease.”
Under the new proposal, in-person visitation would be permitted when discussing or determining a patient’s serious-illness goals or care, or end-of-life decisions such as maintenance or withdrawal of life-saving treatments, and when death of a patient is expected in the near future, as determined by physicians or advance practice medical professionals. Children also could visit their seriously ill parents.
The proposed principles acknowledge the need for balance amid shortages of staffing, adequate personal protective equipment (PPE), and rapid testing availability for anyone entering a medical facility. Visitors must comply with a facility’s PPE policies and may need to sign a liability waiver. They might also need to agree to self-quarantine for 14 days from the day of their last visit to visit again. Facilities should also consider registering visitors of COVID-19 patients and sharing registration records with local health departments in the event of the virus spreading.
The health organizations advise requiring support and clearance for adjusted visitation policy decisions from a facility’s infection control leadership while considering existing rules and regulations.
“We would expect the emergency rules will evolve with time as the rate of virus growth ebbs,” Dr. Fite said. “We hope that by issuing these suggestions we can tend to our patients’ needs beyond just physical ailments, while protecting communities’ health.”